Dr Bhaskar Nandi, HOD, Gastroenterology, Amrita Hospital Faridabad recalls, “I was puzzled about his sadness. He had been living with hepatitis B for many years, and the news that he had seroconverted and had no active virus in his body should have excited him no end. But he remained subdued and stoic. The reason was obvious. There is considerable stigma attached to hepatitis B infection. He confided that getting cured was easy; what was difficult was gaining back his respect and self-confidence.”
A person living with chronic hepatitis faces discrimination at all levels – individual, societal, and institutional. “He has self-guilt and fear of infecting loved ones, disturbed conjugal relations, is wrongly judged as a person with loose morals or as promiscuous, or indulging in substance abuse, and is often denied employment due to positive status. This stigma is unjustified and stems from ignorance of the virus, its infectivity, and spread,” shares Dr Nandi.
A quick search of literature reveals that India harbors around 40 million people who are living with hepatitis B, of which at least a quarter suffer from chronic liver disease, cirrhosis, liver failure, or liver cancer. Less than a third (5-36%) of the general population surveyed had any sort of awareness or adequate knowledge of HBV. This poor awareness in society leads to myths and misconceptions about the disease, resulting in unjustified stigma attached to the infection.
In India, the spread of hepatitis B is predominantly horizontal, where one acquires the infection in childhood due to close contact with a family member who is silently carrying the infection. “Some get it through their mother during birth (vertical transmission). The common perception of acquiring hepatitis B and C through promiscuous sexual activity, contaminated blood or body fluids, or intravenous substance abuse is in the minority. A person living with hepatitis should get all their family members screened for hepatitis B and C and ensure their vaccination,” explains Dr Nandi.
How can one protect the liver and keep it healthy? “Detoxification is a myth. The liver itself is a detoxifying organ and needs no detoxification. Maintaining an ideal body weight and abstaining from alcohol is essential for good liver health and helping the liver fight the infection. All efforts should be directed towards losing weight if one is overweight or obese,” adds Dr Nandi.
A balanced, home-cooked diet with sufficient vegetables and fruits, avoiding frequent intake of deep-fried food, excess oil, butter, refined flour, and soft drinks is recommended for keeping the liver healthy. Exercising and maintaining muscle mass is of paramount importance for people living with hepatitis. A mix of cardio and resistance training, 4-5 days a week for 30-45 minutes each day ensures a healthy liver in the future. Regular follow-up with the treating doctor is imperative.
What can make the lives of people living with hepatitis B easier? “Public health education to increase awareness of hepatitis B, accessible diagnosis and treatment facilities, effective vaccination programs, and the establishment of safe blood transfusion and injection practices create a healthy environment for people living with hepatitis,” signs off Dr Nandi.
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